NPIMap

Organization Active NPI

Micheline Witjenburg PSYD PLLC

  • Clinical Psychologist
  • Norman, OK
National Provider Identifier
1013254440
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1158 Issued in OK
Legal business name
MICHELINE WITJENBURG PSYD PLLC
Practice address
1225 W Main St
Suite 102
Norman, OK 73069-6824
Phone
(405) 292-1000
Fax
(405) 310-4052
NPI assigned
Jan 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Micheline Witjenburg, PSYD
Title
President
Phone
(405) 292-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 1158 OK Primary

Addresses

Primary practice location

1225 W Main St
Suite 102
Norman, OK 73069-6824

Mailing address

1225 W Main St
Suite 102
Norman, OK 73069-6824
Phone (405) 292-1000

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1013254440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W MAIN ST",
            "address_2": "SUITE 102",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696824",
            "telephone_number": "405-292-1000",
            "fax_number": "405-310-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W MAIN ST",
            "address_2": "SUITE 102",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730696824",
            "telephone_number": "405-292-1000",
            "fax_number": "405-310-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELINE WITJENBURG PSYD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-04",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "WITJENBURG",
        "authorized_official_first_name": "MICHELINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-292-1000",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "1158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.